Treatment of Arrhythmia

Minimaze

The Minimaze procedure is a relatively new, minimally invasive, surgical technique used to cure atrial fibrillation (AF). Minimaze is replacing open-heart surgery in some cases of AF and is an alternative to catheter ablation of AF.

In the Minimaze procedure, the cardiac surgeon destroys a small amount of abnormal tissue in the heart that is thought to be the source of the AF. As a result, the destroyed tissue can no longer generate or conduct electrical impulses. The abnormal signal is disrupted, and the heart assumes its normal rhythm.

Who conducts the treatment?
A team of medical professionals, led by a cardiac surgeon and an electrophysiologist, conducts the surgery. The surgeon has special training in arrhythmia surgery. An electrophysiologist is a specially trained cardiologist (heart doctor) who studies and treats the heart’s electrical system.

Close collaboration is important between electrophysiologists and other doctors who treat patients with heart disease. The Heart Rhythm Services medical staff at Oregon Heart & Vascular Institute includes two electrophysiologists.

How is Minimaze done?
The Minimaze procedure uses incisions between the ribs. It is performed on the normally-beating heart (avoiding the need for bypass) and makes only one true incision on the heart. The surgeon places a clamp-like tool on the left atrium near the pulmonary veins. Ablation is performed by heating the atrial tissue between the jaws of the clamp. This cauterizes the area, much like a catheter ablation. The nerves that cause AF are in the area and may be eliminated as well. The surgeon and the electrophysiologist work closely together to ensure that the ablation is complete, and that the overactive nerves are no longer active. In addition, the part of the left atrium (the “appendage”) where most clots form is removed, which may reduce the long-term likelihood of stroke even if AF were to return.